CBHS eClaim (Fast tracked and Standard) Terms and Conditions
In addition to the Additional Conditions of Use of CBHS Member Centre and CBHS Mobile App, the following conditions apply to the use of the CBHS eClaim facility.
Please read these conditions carefully. Your use of this service signifies your acceptance of these conditions of use. In addition, your use of the service is conditional upon accepting the terms and conditions which apply when viewing, accessing or using the CBHS Health Fund Limited (CBHS) website and any online or mobile app services (Site).
What’s claimable, how it works and your obligations.
- Using eClaim, members can submit a claim online for all Extras and Ambulance services claimable from CBHS
- eClaims are still subject to the per service and overall category limits as outlined in the CBHS Health Benefit Fund Rules. Claims can be submitted providing they are not subject to Workers Compensation, third party insurance or a damage claim.
- CBHS will only pay a benefit for services that have been paid in full (with the exception of Ambulance accounts). Should you submit a claim for an unpaid service CBHS reserves the right to deduct any benefit paid immediately.
- eClaims may only be submitted for services received within the last 24 months.
Fast tracked eClaim
- A Fast tracked eClaim service is a service item number that is flagged as a web claimable item.
- For paid services where the sum of all items flagged as web claimable items is below a total of $500, you should normally receive the benefit within 1-2 business days. Fast tracked eClaims can only be paid by direct credit into your nominated CBHS direct credit account.
- If you do not elect to attach your receipts when submitting your claim, receipts need to be sent to CBHS within 10 days in order to verify your claim. The receipts must be accompanied by a printout of the eClaim Form that is displayed at the end of the eClaim process. Alternatively, you can email or fax this form to us, attaching copies of the receipts. CBHS recommends retaining a copy of receipts in the event of loss during the postal process. Future claims using the CBHS eClaim facility and other methods of CBHS claiming using your membership card may be suspended if receipts are not submitted. CBHS may also contact your service provider to validate the service.
- If receipts are not received within the specified time (10 days), CBHS will debit your nominated account in line with the CBHS Direct Debit Request Service Agreement – eClaim, to recoup the funds and cancel the claim. If receipts are received after the specified time, the claim will be processed manually and re-paid into your nominated account. By accepting these terms and conditions, you authorise CBHS to debit your nominated bank account to recoup funds, if receipts are not received by CBHS within 10 days of the claim being made.
- If receipts are not received within the specified timeframe and CBHS attempts to debit your nominated account to recoup the funds paid fails, CBHS may suspend your membership card until the funds or receipts are received. You may also be liable for any fees incurred (ie dishonour fees).
- A Standard eClaim service is a service item number that is not flagged as a web claimable item.
- For paid services, with receipts attached and irrespective of the amount, you should normally receive the benefit within 3-5 business days, from the date CBHS receives the relevant receipts.
- If you do not elect to attach your receipts when submitting your claim, CBHS will not process your claim until we receive your receipts.
Should CBHS not receive receipts to support your Standard eClaim within 30 days your eClaim will be cancelled.
Last updated: 04/01/2017